Active NPI
3130 Medical, LLC
- Nurse Practitioner
- Toledo, OH
National Provider Identifier
1861082877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- 3130 MEDICAL, LLC
- Practice address
- 3130 Central
Ave #23
Toledo, OH 43606 - Phone
- (419) 531-3698
- NPI assigned
- Jan 23, 2021
- Last updated
- Jan 23, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rebecca Murray
- Title
- Representative
- Phone
- (615) 613-3871
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NU | Primary |
Addresses
Primary practice location
3130 Central
Ave #23
Toledo, OH 43606
Mailing address
1712 Pioneer Ave
Ste 500
Cheyenne, WY 82001
Phone (615) 613-3871
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1611360000000",
"number": "1861082877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 PIONEER AVE",
"address_2": "STE 500",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "82001",
"telephone_number": "615-613-3871",
"fax_number": "855-267-9337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 CENTRAL",
"address_2": "AVE #23",
"city": "TOLEDO",
"state": "OH",
"postal_code": "43606",
"telephone_number": "419-531-3698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "3130 MEDICAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-23",
"last_updated": "2021-01-23",
"certification_date": "2021-01-23",
"status": "A",
"authorized_official_last_name": "MURRAY",
"authorized_official_first_name": "REBECCA",
"authorized_official_title_or_position": "REPRESENTATIVE",
"authorized_official_telephone_number": "615-613-3871"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.